Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
Showing 4 appraisals
Medical science monitor : international medical journal of experimental and clinical research
Impact of Gross Motor Coordination Exercises on Perceptual Processes and Praxis in Early School Children With Symptoms of Developmental Coordination Disorder: Preliminary Report of Randomized Controlled Study
BACKGROUND Physical activity has a general impact on cognitive processes, but evidence on the effects of specific exercises on particular cognitive or executive functions remains limited. Previous studies suggest that movements crossing the body's midline stimulate excitability and plasticity in the dorsolateral prefrontal cortex and superior parietal cortex. This study aimed to investigate whether such exercises produce long-term functional changes in these areas. MATERIAL AND METHODS The study involved 22 children aged 6 to 8 years with symptoms of developmental coordination disorder (DCD), divided into 2 equal groups. Both groups completed approximately 9 weeks of coordination training based on Bilateral Integration by Sheila Dobie OBE (the total diagnostic and therapeutic cycle lasted approximately 16 weeks, including a break). The intervention group performed exercises involving midline crossing, while the control group performed exercises without this element. Assessments (sensory integration and praxis tests and the bilateral motor coordination test) were conducted 3 times: before intervention, after 9-week program, and at follow-up. RESULTS Significant improvements were observed in both groups in sequencing praxis (P=0.041 in the control group; P<0.001 in the intervention group) and bilateral motor coordination (P=0.013; P=0.020), but at different rates. In the intervention group, improvements appeared after the intervention, while in the control group only at follow-up. Large effect sizes were found (η² ϵ [0.293, 0.670]), with high statistical power. No significant changes were observed in other functions. CONCLUSIONS The Bilateral Integration method improves sequencing praxis and interhemispheric integration in children with DCD symptoms. Midline-crossing exercises may yield relatively fast improvements in short-term programs.
11 June 2026
Read appraisal →Proceedings of the National Academy of Sciences of the United States of America
Discovering regularity and mechanisms of word sense acquisition in childhood.
How does language use inform the emergence of word meanings in early life? Prior work in developmental psychology and the cognitive sciences typically focuses on studying word acquisition in children without specifying how different senses within a word emerge through time. To shed light on word sense acquisition, we propose a framework grounded in state-of-the-art computational methodologies of contextual word embedding to characterize how different senses of a word unfold as children acquire their lexicon. Our framework identifies word senses automatically by forming semantic clusters through natural language use, and analyzes 1,270 words from approximately 4 million utterances produced by children (19 to 144 mo) and their caretakers. The psychological validity of these senses was assessed based on a combination of dictionaries, human judgment of semantic similarity, and evaluation from a large language model. We then tested three hypotheses motivated by existing work on word sense emergence in language evolution. First, concrete senses of a word tend to emerge earlier than more abstract senses in child language. Second, word senses grow incrementally in semantic space across development. Third, algorithms of semantic chaining-how words spawn new senses by extending from existing senses-recapitulate the order of word senses in development. We find support for all three hypotheses. Our work suggests that the development of word meaning in language acquisition resembles that in language evolution and offers a converging view on the cognitive principles and mechanisms across timescales in the ontogeny and phylogeny of word sense emergence.
13 May 2026
Read appraisal →BMJ open
Multimodal personalised executive function intervention (E-Fit) for school-aged children with complex congenital heart disease in Switzerland: a randomised controlled feasibility study
OBJECTIVE: To explore the feasibility of a novel multimodal executive function intervention in school-aged children with complex congenital heart disease (cCHD). DESIGN: Single-centre, single-blinded, randomised-controlled 8-week multimodal personalised executive function intervention (E-Fit) study. Outcomes were measured throughout the intervention, post-intervention (T1) and at 4-month follow-up (T2). SETTING: Tertiary care centre between May 2022 and May 2024. PARTICIPANTS: Children 10 to 12 years (M=11.0, SD=0.9) with cCHD without a genetic diagnosis with infant open-heart surgery and reported difficulties (T-scores ≥60) on any of the summary scales of the parent- or teacher-reported Behavior Rating Inventory for Executive Function (BRIEF). INTERVENTIONS: Children with cCHD were randomly assigned to one of two groups: the intervention or the control group. The 8-week intervention was multimodal including three modalities: (1) computerised executive function (EF) training 3×20 min/week with CogniFit; (2) a weekly, remote standardised 1:1 individual EF strategy coaching; (3) analogue games played at convenience. The control group completed activity logs. FEASIBILITY MEASURES: Acceptability: Acceptance and Feasibility Scale (AFS) and coach-rated engagement during coaching sessions. Demand: Number of completed computerised training, strategy coaching and analogue game sessions. IMPLEMENTATION: E-Fit Fidelity Measurement System, assessing adherence to core components. Practicality: Retention rate. Integration: AFS integration items. Exploratory efficacy: BRIEF, neuropsychological EF testing and psychosocial variables at baseline, post-intervention (8 weeks) and at 4-month follow-up. RESULTS: We recruited 42 participants (Nfemale=20). Acceptability: The intervention was acceptable, with moderate observed engagement. Demand: median number of computerised training sessions completed was 16 of 24 sessions (67%, (IQR; 6 to 19)), all children attended all scheduled coaching sessions, analogue games were played in total a median of 9 times (IQR 4 to 14). IMPLEMENTATION: Coaching sessions could be implemented by the coaches as intended. Practicality: Overall retention rate was 90%. Integration: E-Fit was well integrable into the home setting. Exploratory efficacy favoured the intervention group with improvements in the parent-rated Behavioral Regulation Index of the BRIEF (adjusted Hedge's (gA1) = -0.408 to -0.903) and in social responsiveness (gA1 = -0.427 to -0.521) at T1 and at T2. CONCLUSIONS: E-Fit is a feasible intervention suggesting EF and social responsiveness improvements in children with cCHD. Motivational strategies to improve adherence to computerised training should be refined before a full-scale efficacy trial. TRIAL REGISTRATION NUMBER: NCT05198583.
12 May 2026
Read appraisal →Journal of medical Internet research
A Health-Related Digital Ecological Momentary Assessment in Children (Aged 5-11 Years): Systematic Review
BACKGROUND: Digital ecological momentary assessment (EMA) collects data on experiences as they occur in daily life, capturing dynamic, context-sensitive experiences often missed by retrospective reporting. While EMA shows promise for pediatric health research, preadolescents have distinct socioemotional and cognitive characteristics likely to affect engagement. Existing reviews have not focused on the acceptability and feasibility of EMA protocols for this age group. OBJECTIVE: This review aimed to examine digital EMA protocols used with children aged 5-11 years across health domains, focusing on protocol characteristics, acceptability, and feasibility. We address 3 research questions (RQs)-RQ1: What are the characteristics of these protocols? RQ2: What is the feasibility and acceptability of these protocols? RQ3: What are the characteristics of high and low response rate protocols? METHODS: We searched 10 databases (CINAHL, Embase, ACM Digital Library, IEEE Xplore, Cochrane Library, PsycINFO, Web of Science, PubMed, Scopus, and MEDLINE) for peer-reviewed studies published up to October 2025. Eligible studies used EMA with children aged 5-11 years to collect health data via digital devices. Two researchers independently screened studies (SC and LT); one (SC) conducted quality assessment and data extraction. Findings were narratively synthesized. RESULTS: We identified 17 protocols across 37 studies. Most targeted nonclinical populations, used handheld devices, spanned 3-28 days, and applied interval-contingent prompting (RQ1). Response rates were available or calculable for 15 of 17 protocols, ranging from 48% to 92% (RQ2). Six protocols reported response rates of ≥80%. However, key data required for pooling (eg, raw counts for planned vs completed prompts) were missing or selectively reported. This contributed to 13 of 17 protocols being rated at critical risk of bias (ROBINS-I, v2). As a result, the strength of evidence was limited by poor reporting and high risk of bias. Facilitators included uncomplicated, engaging technology, reminders, and caregiver involvement. Barriers included device burden, restricted device access, difficulty with accurate reporting, stigma, limited device awareness, and insufficient caregiver support. High-response protocols (≥80%) often involved older children or clinical groups, ≥3-week duration, fixed schedules (≥20 items per prompt, 3 or 4 times per day), timing customization, and incentives (RQ3). CONCLUSIONS: This review provides the first systematic synthesis on preadolescents, offering insight into EMA protocol design beyond prior work treating children as a single group. By examining 17 EMA protocols, the review identifies gaps in developmental appropriateness and reporting quality, highlighting where the evidence may differ from adolescent and adult EMA research. The results suggest that digital EMA for preadolescents requires greater focus on child-centered design to increase acceptability and adherence, alongside improved reporting standards, so protocols can be meaningfully compared. With these advances, EMA could be more effectively integrated into pediatric health monitoring, tailored to the needs of different age groups.
16 Apr 2026
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